Job Details

Overall Responsibility:

Perform all data entry functions necessary for accurate and timely daily processing, such as performing computer billing routines, performing end of month/year procedures. Performs all appropriate collection activities to obtain full reimbursement and payment from patients and third party payors.

Key tasks and responsibilities (essential functions):

• Maintains and tracks all scheduled cases for accurate billing.
• Performs the input of all charges, prints and/or sends claims, statements and reports for primary, secondary and tertiary balances, according to the policy manual.
• Prices and prepares charges for all procedures in accordance with contractual provisions.
• Enters patients charges to the A/R system, prepares adjustment, deletions and corrections for approval and posting for the Business Office Manager.
• Receives front desk deposits to include monies, receipts and cash journal entries.
• Responsible for making sure all patient data in computer is complete and accurate
• Relieves Front Desk staff when needed.
• Works all payer acceptance/rejection reports to ensure proper processing of claim submissions.
• End of day/month reporting procedures and ensures that all computer report printouts are properly stored.
• Refers difficulties or problems involving billing and collection efforts immediately to the Manager.
• Monitors accuracy, timeliness and completeness of patient accounts, including; demographic, insurance, referral and pre-certification information.
• Maintains complete and accurate files of all insurance information and contracts. Keep abreast of insurance changes and requirements. Ensure that up to date carrier information is maintained in the computer.
• Maintains and handle maintenance of system relating to patient accounting.
• Maintains adequate computer supplies on hand, e.g., paper, insurance forms, ribbons, etc.
• Provides for billing, invoice for surgical supply if needed.
• Helps maintain patient confidentiality standards for both medical and financial information.
• Keeps job related skills current through training programs.
• Participates in all compliance programs.
• Participates in loss prevention by protecting company assets and maintaining a safe environment.
• Performs other related duties incidental to the work required in this job description.

Licensure and Certification: BCLS preferred.

Education/Skills: High school diploma or equivalent required. Good interpersonal skills, excellent telephone etiquette, good verbal and written communication skills. Detail oriented with good organizational skills and ability to maintain accuracy while meeting daily deadlines.

Experience: At least one year experience in billing/patient account management in a healthcare setting preferred. Proven knowledge of correct collection practices, knowledge of Medicare Compliance billing guide, Medicare/Medicaid and Managed Care contracts preferred. Knowledge of global and bundling coding guidelines preferred.

Physical Requirements: Candidate must be able to read and speak English fluently, have cognitive skills for math, reading, computer skills, and communication skills to deal well with the public (customers) as well as peers. Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires communication skills to deal well with employees, patients, families, physicians and vendors. May require lifting of 20-30 pounds maximum, potential for exposure to blood and body fluids (minimal), and exposure to infectious disease.